25-羟基维生素D_3对SLE患儿CD19^+ B7分子表达及dsDNA-NcX抗体的影响

The effect of 25-hydroxy vitamin D_3 on the expression of CD19^+ B7 and dsDNA-NcX antibody in children with SLE

目的研究25-羟基维生素D_3[25-(OH)D_3]水平对儿童系统性红斑狼疮(SLE)患者外周血CD19^+ B7-1(CD19+CD80)和B7-2(CD19+CD86)及高敏抗双链DNA-Nc X(dsDNA-NcX)抗体表达的影响。方法根据SLEDAI评分将58例SLE患儿分为活动期组和稳定期组,采用电化学发光法测定血清25-(OH)D_3水平,将血清25-(OH)D_3低于20 ng/ml定义为D_3缺乏组,介于20 ng/ml^30 ng/ml为D_3不足组;另设50例健康体检儿童为对照组。以流式细胞术检测外周血CD19+B7-1、B7-2分子表达。ELISA法测定血清dsDNA-NcX抗体水平,并分析各项检测指标之间的相关性。结果 SLE活动期组血清25-(OH)D_3水平显著低于稳定期组和对照组,而CD19+B7-1、B7-2分子及dsDNA-NcX抗体则明显高于稳定期组和对照组;D_3缺乏组CD19+B7-1和B7-2分子与dsDNA-NcX抗体水平也显著高于D_3不足组,组间比较差异均有统计学意义(P<0.01)。SLE患儿血清25-(OH)D_3水平与CD19+B7-1和B7-2分子、dsDNA-NcX抗体及SLEDAI评分呈负相关(P<0.01),而CD19+B7-2分子与dsDNA-NcX抗体及SLEDAI评分呈正相关(P<0.01)。结论 SLE患儿血清25-(OH)D_3水平降低,外周血CD19+B7分子表达增强,导致B淋巴细胞过度合成dsDNA-NcX抗体,可能参与了儿童SLE的发生与进展。

Objective To study the effect of the serum levels of 25-hydroxyvitamin D_3[25-（ OH） D_3]in children with SLE on the expression of CD19~＋ B7-1（ CD19~＋ CD80）,B7-2（ CD19~＋ CD86） and high sensitive dsDNA-NcX antibody（ dsDNA-NcX）. Methods 58 patients with SLE in our hospital were selected as the research objects,according to the SLEDAI score,and divided into the active group and the inactive group; the levels of 25-（ OH） D_3 in serum were determined by electrochemiluminescence immunoassay,that below 20 ng/ml was defined as D_3 deficiency group,ranging from 20 ng/ml to30 ng/ml as D_3 insufficient group; another 50 cases of healthy children were selected as the control group. Flow cytometry was used to detect the expression of CD19~＋ B7-1 and B7-2 in peripheral blood. ELISA method was used to determine the serum levels of dsDNA-NcX antibody,and the correlation between the serum levels of 25-（ OH） D_3 and other indexes was analyzed. Results The serum levels of 25-（ OH） D_3 in the active group were significantly lower than those in the inactive group and the control group,but the expression of CD19~＋ ,B7-2 and dsDNA-NcX antibody was significantly higher than that in inactive group and the control group; the expression of CD19~＋ B7-1 and B7-2 and dsDNA-NcX antibody in D_3 deficient group was significantly higher than those in D_3 insufficient group,with the differences between groups statistically significant（ P〈 0. 01）. The serum levels of 25-（ OH） D_3 in children with SLE were negatively correlated with CD19~＋ B7-1 and B7-2 molecules,dsDNA-NcX antibody and SLEDAI score（ P 〈0. 01）,while CD19~＋ B7-2 was positively correlated with dsDNA-NcX antibody and SLEDAI score（ P〈 0. 01）. Conclusion The levels of serum 25-（ OH） D_3 in children with SLE decreased,and the expression of CD19~＋ B7-2 in peripheral blood increased,which lead to the excessive synthesis of dsDNA-NcX antibody in B lymphocytes,and may be involved in the occurrence and progression of SLE in children.